Pharmacological therapy and dietary intervention for obesity management: A one-year prospective cohort study in Baghdad.
- 1Department of Family and Community Medicine, College of Medicine, Ibn Sina, University of Medical and Pharmaceutical Sciences, Baghdad, Iraq.
Abstract
Background
Evidence directly comparing long-term pharmacological therapy and structured dietary intervention for obesity in Middle Eastern populations is limited. This study provides 12-month real-world comparative data from specialized obesity clinics in Baghdad, Iraq.Materials and methods
A prospective cohort study included 120 adults with obesity (BMI ≥30 kg/m²) from June 2024 to June 2025. Participants received either pharmacological therapy (orlistat 120 mg three times daily or liraglutide 3.0 mg/day; n = 60) with standard lifestyle advice, or intensive individualized dietary counseling by board-certified dietitians (n = 60). The primary outcome was percentage weight loss at 12 months. Secondary outcomes assessed body composition, metabolic parameters, physical activity, adherence, adverse effects, and quality of life. Between-group differences were analyzed using independent t-tests with exact P values and 95% confidence intervals.Results
At 12 months, pharmacological therapy associated with greater early weight loss but reached a plateau (13.5 ± 3.7% vs. 11.3 ± 4.3%, P < 0.001; 95% CI: 1.1-2.8%). Dietary intervention associated with higher fat-mass loss (68.9% vs. 53.1%, P < 0.001), better lean-mass preservation (P = 0.003), and superior improvements in LDL-cholesterol (P = 0.012), fasting glucose (P = 0.047), systolic blood pressure (P = 0.041), and physical activity (P = 0.001). Adherence (73.3% vs. 58.3%, P = 0.038) and patient satisfaction (P < 0.001) were higher with diet, while gastrointestinal side effects were more common with pharmacotherapy (68.3% vs. 11.7%, P < 0.001).Conclusions
Intensive dietary counseling yielded to superior long-term metabolic, behavioral, and patient-centered outcomes with better adherence, supporting its use as a first-line obesity treatment. Pharmacological therapy may be an adjunct for selected patients, highlighting the importance of structured, dietitian-led lifestyle programs within health systems.
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BibTeX
@article{alatta2026pharmacological,
title = {{Pharmacological therapy and dietary intervention for obesity management: A one-year prospective cohort study in Baghdad.}},
author = {Duaa Mohammed Al-Atta and Sura Talal Kadhim and Monaf Faik Al-Samarraee},
journal = {Journal of education and health promotion},
year = {2026},
month = sep,
doi = {10.4103/jehp.jehp_2134_25},
url = {https://europepmc.org/article/MED/42924324},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Pharmacological therapy and dietary intervention for obesity management: A one-year prospective cohort study in Baghdad.
AU - Duaa Mohammed Al-Atta
AU - Sura Talal Kadhim
AU - Monaf Faik Al-Samarraee
PY - 2026
DA - 2026/09/30
JO - Journal of education and health promotion
DO - 10.4103/jehp.jehp_2134_25
UR - https://europepmc.org/article/MED/42924324
AB - Background Evidence directly comparing long-term pharmacological therapy and structured dietary intervention for obesity in Middle Eastern populations is limited. This study provides 12-month real-world comparative data from specialized obesity clinics in Baghdad, Iraq.Materials and methods A prospective cohort study included 120 adults with obesity (BMI ≥30 kg/m²) from June 2024 to June 2025. Participants received either pharmacological therapy (orlistat 120 mg three times daily or liraglutide 3.0 mg/day; n = 60) with standard lifestyle advice, or intensive individualized dietary counseling by board-certified dietitians (n = 60). The primary outcome was percentage weight loss at 12 months. Secondary outcomes assessed body composition, metabolic parameters, physical activity, adherence, adverse effects, and quality of life. Between-group differences were analyzed using independent t-tests with exact P values and 95% confidence intervals.Results At 12 months, pharmacological therapy associated with greater early weight loss but reached a plateau (13.5 ± 3.7% vs. 11.3 ± 4.3%, P < 0.001; 95% CI: 1.1-2.8%). Dietary intervention associated with higher fat-mass loss (68.9% vs. 53.1%, P < 0.001), better lean-mass preservation (P = 0.003), and superior improvements in LDL-cholesterol (P = 0.012), fasting glucose (P = 0.047), systolic blood pressure (P = 0.041), and physical activity (P = 0.001). Adherence (73.3% vs. 58.3%, P = 0.038) and patient satisfaction (P < 0.001) were higher with diet, while gastrointestinal side effects were more common with pharmacotherapy (68.3% vs. 11.7%, P < 0.001).Conclusions Intensive dietary counseling yielded to superior long-term metabolic, behavioral, and patient-centered outcomes with better adherence, supporting its use as a first-line obesity treatment. Pharmacological therapy may be an adjunct for selected patients, highlighting the importance of structured, dietitian-led lifestyle programs within health systems.
SN - 2277-9531
SN - 2319-6440
ER -